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auditing coding healthcare fraud data privacy📋 Description
- Execute Oscar's anti-fraud initiatives within the SIU Coding Auditor program.
- Support audit strategy to meet targets while ensuring quality and regulatory compliance.
- Collaborate across partners and recommend process improvements for Fraud, Waste and Abuse.
- Review dashboards and interpret performance data to support production goals and deadlines.
- Perform complex reviews of medical records and claims (pre- and post-payment) for accuracy.
- Document findings with sources and present clearly to providers and non-clinicians.
🎯 Requirements
- Bachelor's degree or equivalent years of experience.
- CPC designation or similar.
- 3+ years coding or auditing experience across multiple specialties.
- Bonus: Certified Professional Medical Auditor (CPMA) or similar.
- Bonus: Additional certifications such as CFE, AHFI, or CAFP.
- Bonus: HIPAA, data privacy, and data security knowledge; experience with regulators.
🎁 Benefits
- Medical, dental, and vision benefits; 11 paid holidays; paid sick time; parental leave; 401(k) plan.
- Life and disability insurance; wellness time and reimbursements.
- Unlimited vacation program and annual performance bonuses.
- Remote-friendly work arrangement; occasional travel for team meetings and events.
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